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November 1980

Charcoal Hemoperfusion in the Therapy for Methsuximide and Phenytoin Overdose

Arch Intern Med. 1980;140(11):1466-1468. doi:10.1001/archinte.1980.00330220042016

• Two patients suffered overdoses of anticonvulsant drugs. The first patient took methsuximide and the second, phenytoin. Because of profound CNS depression, both patients underwent hemoperfusion with a cellulose-activated charcoal hemoperfusion column. The primary metabolite of methsuximide, N-desmethylmethsuximide, primarily was responsible for the CNS depression in the first patient. The clearance of N-desmethylmethsuximide by the charcoal column was high, and clinical improvement became apparent during the hemoperfusion period. The clearance of phenytoin, on the other hand, was much lower than that of N-desmethylmethsuximide, and there was no apparent clinical improvement in that patient's condition.

(Arch Intern Med 140:1466-1468, 1980)